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ahh, Raccaniello.
Thinks the whole H5N1 is nothing to be afraid of, because
some other people exaggerated the threat.
Incorrectly, as he thinks.
Now the CFR is not 50% but only ... maybe 10%.
Nothing to worry about.
I mean, when you wanted to dismiss H5N1, then you'd argue
about the probability that it happens.
OK, he does that too, the ferrets were different from humans.
Well, maybe, maybe not. He is just looking for small factors to reduce
the threat.
Like saying nuclear war were no big danger since the earlier
estimates of the overkill capicity were too large.
We'd only die 10 times instead of 20 times ...
"I know God will not give me anything I can't handle. I just wish that He didn't trust me so much." - Mother Teresa of Calcutta
Palese:
> After we published our full paper…researchers poured into the field who probably
> would not otherwise have done, leading to hundreds of papers about the 1918 virus.
those researchers would likely have published papers about other things else.
Less valuable ? That's not clear at all.
> As a result, we now know that the virus is sensitive to the seasonal flu vaccine,
...more than expected. So the danger is small ? Well, we still have seasonal waves each year
despite vaccine and despite partial immunity real infections.
This can be as bad (in terms of spreading) as 2003/4 which was almost pandemic like with
just a new variant of H3N2 only ~5 years of normal evolution away from the vaccine.
And afair the protection is very small, (Palese et.al. paper testing mice, discussed here)
the ****** outbreak should provide larger protection against the 1918 virus.
> as well as to the common flu drugs amantadine (Symmetrel) and oseltamivir (Tamiflu).
this can easily be "undone" by single mutations, as we now know.
> Had we not reconstructed the virus and shared our results with the community,
> we would still be in fear that a nefarious scientist would recreate the Spanish flu
> and release it on an unprotected world. We now know such a worst-case scenario
> is no longer possible.
do we ? The 1918 virus released today would have to compete (via immunity) with ******,
which is more "advanced" wrt. spreading in our modern society.
But this will likely change in some decades or centuries when the 1918 virus may
become a threat again.
> The more danger a pathogen poses, the more important it is to study it (under appropriate
> containment conditions), and to share the results with the scientific community.
> Slowing down the scientific enterprise will not ‘protect’ the public —
> it only makes us more vulnerable.
but is it necessary to make that virus easily available to the masses ?
I'd expected that research to be done as research on nuclear bombs, i.e. nonpublic details,
nonproliferation treaties etc.
Palese:
> We then took an existing influenza virus and, one by one, swapped its genes
> with those from the 1918 virus, eventually recreating a live version
could that be easily redone by terrorists ?
> Giving the full details to vetted scientists is neither practical nor sufficient.
would he be one of those ?
> Once 20–30 laboratories with postdoctoral fellows and students have such
> information available, it will be impossible to keep the details secret.
so do it in military grade labs only ?!
> “Who will want to enter a field in which you can't publish your most scientifically
> interesting results?”
this would only be a small special (sub)field.
I could ask: what research are we,the public, willing to pay for ?
> Knowing which mutations render the virus more dangerous could help on a
> public-health level — if an outbreak of bird flu occurs in Taiwan, for instance,
> and researchers sequence the virus and see those mutations, we would know
> to ramp up the production of appropriate vaccines and antiviral drugs.
ahh, if an outbreak of bird flu occurs in Taiwan, then we should ramp up the production
anyway - no matter if those mutations were included or not
> Incidentally, I believe that the risk of future outbreaks in humans is low: H5N1 has
> had the opportunity to cause widespread pandemics for many, many decades,
> yet it has not done so.
and I remember that's exactly why Palese concluded in 2006 that H5N1 were just not capable
of this. Does he still think so after the Fouchier/Kawaoka experiments ?
****** needed 13 years to take off. Equine H3N8 needed 40 years before it jumped to dogs.
H5N1 had had not enough opportunities yet to evolve 10 or more generations in humans
as Fouchier did with the ferrets.
> Although we know the virus is transmissible between ferrets,
> little is known about how it will behave in other animals, including humans.
so how can Palese conclude :
"Incidentally, I believe that the risk of future outbreaks in humans is low:"
"little is known" is no negative evidence
if they had done Fouchier/Kawaoka like experiments
with triple-reassortant swine flu 5 years ago ,
would they have found the pandemic danger from ****** ?
Well, they would have let it reassort with European Swine H1N1
also.
But they could/should have found it ?!?
Seems to me that this is all
just a matter of funding.
What did they pay to Kawaoka,Fouchier groups ?
Who decided that funding and when ?
I mean, H5N1 was a threat since 1997
(triple Swine since 1998)
now H5N1,H9N2, European Swine H1,re-emergence of H2N2
<DL class=citation><DT>Journal name:<DD class=journal-title>Nature<DT>Year published:<DD>(2012)<DT>DOI:<DD class=doi>doi:10.1038/481257a</DD></DL><DL class="citation dates"><DT class="published-online first">Published online<DD><TIME datetime="2012-01-15" pubdate="pubdate">15 January 2012 </TIME></DD></DL></HEADER><SECTION>A proposal to restrict the planned publication of research on a potentially deadly avian influenza virus is causing a furore. Ten experts suggest ways to proceed.
Erasmus MC, Rotterdam, the Netherlands
So far, most of the human deaths from the deadly H5N1 strain of bird flu have occurred in Asia and the Middle East. Many labs worldwide ? including ours ? are trying to understand what makes the virus so virulent, and how to stop it. H5N1 research is thus a global issue, yet the entire research community seems to be following the advice of one country.
We are not questioning the unprecedented recommendations last month from the US National Science Advisory Board for Biosecurity (NSABB) to remove key details from the methods and results sections of published papers, including our own, submitted to Science (see Nature481, 9?10; 2012). But we do question whether it is appropriate to have one country dominate a discussion that has an impact on scientists and public-health officials worldwide. This discussion should include the perspective of people in regions where H5N1 has infected humans. Will the NSABB also advise on which international researchers and officials have the right to see the full papers, to help implement urgently needed surveillance and other intervention strategies?
It is not clear whether an international discussion would lead to different recommendations. There is no global equivalent of the NSABB, but many European experts that we have seen quoted in the press believe that the research should be published in full. We don't know the worldwide opinion until a group of experts from all parts of the globe is formed. An issue this big should not be decided by one country, but by all of us.
"Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear." -Nelson Mandela
Despite government alarms bells, recent research with ferrets didn't create flu strains that threaten the world.
If you were paying attention to the flap over two recent flu experiments involving ferrets, you may have come away with the impression that scientists all but waved a red flag in front of terrorists and said, "Here's a perfect biological weapon ? help yourselves."
But there's really not much cause for alarm.
- snip -
But the idea that these laboratory-created mutations could now pop up together in some Asian chicken and launch a lethal pandemic is implausible. That's not how evolution works. Evolutionary biologist Paul Ewald of the University of Louisville predicted in 1993 that packing chickens in factory farms would allow the evolution of lethal chicken viruses. And that's exactly what happened: Chicken viruses evolved that killed chickens.
- snip -
None of this is to say, however, that the ferret experiments weren't important. What they showed is how quickly natural selection can transform a virus.
"You put selection pressure on the system for increased transmissibility, and you quickly get the outcome that you expect to get," says Ewald.
- snip -
The 1918 flu, which killed some 50 million people worldwide, was formed in the massive disease factory of the Western Front of World War I. Why was it a disease factory? Because soldiers were crowded into close quarters that were the perfect environment for the flu to mutate into something highly virulent. When a soldier got deathly ill, there was no place to move him, and he remained packed tightly in among the other soldiers.
The 1918 flu virus eventually lost its virulence as the conditions that gave rise to it abated. When a virus depends on a mobile host to transmit it, as normal human flu viruses do, there's a limit to its virulence. Once humans aren't crowded so tightly together, it's the milder strains of viruses that natural selection favors, because transmission is more easily accomplished if the infected person feels well enough to be out in public sneezing and coughing instead of taking straight to a sickbed where few other people are likely to be infected.
Could that be because there is no Bio-Threat industry outside of the United States?
While I have read of 'nefarious actors' who some in the industry fear are out to cause global Armageddon I am not clear who the industry think they are, nor have seen any evidence that there is a threat of this type.
Here I am talking of the release of an untargetable bio-weapon which would require a significant investment of time and resources by a body of technically knowledgeable people.
That there are people who hate all I stand for and are willing to kill my ilk in quantity, given a chance, I don't doubt but that is not what we are talking about if you are censoring H5N1 research or worrying about re-animating H1N1(1918) from its sequence data.
Looking at the list of members of the NSABB I see many good scientist for whose work I have much respect. I also however see a list of institutions who collectively get a significant chunk of funding which might evaporate if the threat was down graded.
Not really the group I think should be leading this discussion.
These are my personal views and not those of any other body.
For those who may not know exactly what and who NSABB is:
The NSABB is a federal advisory committee chartered to provide advice, guidance, and leadership regarding biosecurity oversight of dual use research, defined as biological research with legitimate scientific purpose that may be misused to pose a biologic threat to public health and/or national security.
The NSABB is charged specifically to:
Recommend strategies and guidance for enhancing personnel reliability among individuals with access to biological select agents and toxins.
Provide recommendations on the development of programs for outreach, education and training in dual use research issues for scientists, laboratory workers, students and trainees in relevant disciplines.
Advise on policies governing publication, public communication, and dissemination of dual use research methodologies and results.
Recommend strategies for fostering international engagement on dual use biological research issues.
Advise on the development, utilization and promotion of codes of conduct to interdisciplinary life scientists, and relevant professional groups.
Advise on polices regarding the conduct, communication, and oversight of dual use research and results, as requested.
Advise on the Federal Select Agent Program, as requested.
Address any other issues as directed by the Secretary of HHS.
The NSABB is chartered to have up to 25 voting members with a broad range of expertise including molecular biology, microbiology, infectious diseases, biosafety, public health, veterinary medicine, plant health, national security, biodefense, law enforcement, scientific publishing, and related field. The NSABB also includes nonvoting ex officio members from 15 federal agencies and departments.
This educational video was produced by the National Institutes of Health (U.S. Department of Health and Human Services) to raise awareness and understanding about the issue of dual use life sciences research. The video offers a conceptual introduction to the issue and features interviews with some of the country's leading experts who discuss the need to ensure scientific progress while ensuring appropriate oversight. The target audience includes life scientists, trainees and students, research administrators, and the general public.
"Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear." -Nelson Mandela
But to become a world-destroying pandemic, a virus would need a so-called human disease factory in which to refine its mutations. . .
The 1918 flu, which killed some 50 million people worldwide, was formed in the massive disease factory of the Western Front of World War I.Why was it a disease factory? Because soldiers were crowded into close quarters that were the perfect environment for the flu to mutate into something highly virulent. When a soldier got deathly ill, there was no place to move him, and he remained packed tightly in among the other soldiers.
According to Ms. Orent it was densely packed soldiers in Europe in 1918 that allowed the virus to mutate and spread. This is a naive view of the pandemic. The spread of the infectious disease, as measured the R0, is primarily a function of the transmissibility of the novel virus, not the density of potential victims. If that were true, H5N1 would have already caused a pandemic.
At the time of the H1N1 pandemic in 1918 the population in all of Europe was 250 million people (Mortality burden of the 1918?1919 influenza pandemic in Europe). Today, Europe has a population of over 840 million (link). And there are four countries in the world with current populations that exceed 200 million people, China, India, United States, and Indonesia (link). Of these, China and Indonesia have already reported human H5N1 cases, and human H5N1 case are likely to have occurred in India but have not been officially reported. The density of people in some areas of these countries greatly exceeds the density of Orent's 1918 "disease factories".
Countries such as China, Indonesia, and India could already be "disease factories" for human H5N1 mutations. So far, we are lucky that the virus has not yet become sufficiently transmissible to break out of local clusters.
Maybe the increased traffic with military ships contributed
to the spread, though.
But then, as we know now, less naval traffic would only have delayed it.
Comment: Fouchier is in a position to know, and in light of the information below, I am clarifying my position as follows:- a) an essential need for all indivduals carrying out research on H5N1 to be made fully aware of the full information contained in the Fouchier research and b) that active work on the Fouchier team developed virus should be confined to BL4 labs... but if we have naturally occurring virus that is this close to transmissibility it argues for increased levels of research to find new interventions as a matter of extreme urgency for the world.
Perhaps the natural proximity of some viruses to full transmissibility is what has triggered the concerns by Biosecurity organisations over this whole issue; Fouchier and his team make very good points.
Excerpts from Fouchier Reuters interview
In an opinion piece published in Science on Thursday, Fouchier argued for the release the research to help public health officials better prepare for a scenario where the virus could mutate and become more deadly, spreading from person to person via coughs and sneezes. He emphasized that other researchers are close to the same findings, some of them inadvertently, and should be warned in advance how the virus could become airborne.
"We have identified, from the published literature, laboratories working with H5N1 viruses that may only require one to three mutations before the viruses used may become transmissible" via airborne particles, the Erasmus team wrote.
They did not identify the other laboratories, though other experts say they include facilities in both government and academia. "We want them to be careful," Fouchier said in an interview. "They did not know that they were one or two or three mutations away" from having an easily transmissible mutant virus.
I am happy to second Vibrant62's recommendation to read Fochier et al in full.
One thing they have addressed is the impact this may all have on the PIP Framework. The legality of the attempted censorship, under PIP, has been bothering me.
I can not see the point of trying to limit the publication to 'those who need to know' who ever some well meaning group might think that includes if that group will need to include almost everyone capable of reproducing the experiment. The only people who will have to wait to see data are people like us who are not virologists but are sufficiently interested to read papers like this and look at, and try and understand, sequence data. The situation is already bad enough with sequences often not openly available until they are so old they throw little light on the currently circulating strains.
For those not familiar with the PIP Framework a little background and some links.
Since 1952 the WHO have had an influenza surveillance system which now includes about 150 labs in over 100 countries.
Countries were freely supplying samples and data to the system until a few years ago, but some thought the system was not working to their advantage and started to withhold data and samples. The main bone of contention was that commercial vaccine and antiviral manufactures were getting access to the system but their products were unaffordable to the bulk of the populations in the poorer members of the system.
The problem became more acute with the possibility of a high virulence pandemic based on AIHP H5N1 as all the vaccine plants and most of the antiviral production was based in the richer industrialised nation and there was little chance any of it would flow outside the hosting countries in a severe pandemic.
The negotiations to resolve this problem have been very difficult but in May 2011 the PIP Framework was adopted by the 64th World Health Assembly. The new system renames the Global Influenza Surveillance Network (GISN) to Global Influenza Surveillance and Response System (GISRS) into which samples are sent, logged and subsequently tracked. All the labs in this system have to sign an agreement to get access and agree to share any data derived form these samples. Labs, Pharmaceutical companies and anyone else interested in getting access to the samples have to negotiate with WHO and will be required to input something back into the system. For-instance the manufactures have agreed to fund 50% of the GISRS's running cost as part of their agreements. The agreement also covers technology transfer, pandemic vaccine and seasonal vaccine transfers to poor countries. How these will work in practice remains to be seen as the wording is very weak "Member States should urge vaccine manufacturers to set aside a portion of each production cycle ...". The PIP Framework can be downloaded as a .pdf here. and there is a PIP Q&A here.
As can be seen form the above the GISRS labs alone are 150 in number and situated in 100 countries so how limited can the 'need to know' list be without breaching the terms of the PIP Framework?
Ron Fouchier of Erasmus Medical College in the Netherlands, Adolfo Garcia-Sastre of Mount Sinai School of Medicine in New York, and Yoshihiro Kawaoka of the University of Wisconsin, Madison have suspended their research
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